Traditional role, new innovations highlighted
In response to a series of articles about nosocomial infections in the Chicago Tribune, the Centers for Disease Control and Prevention (CDC) in Atlanta, and the Association for Professionals in Infection Control and Epidemiology (APIC) in Washington, DC, issued statements. Some of the key points made by the CDC and APIC are summarized as follows:
• APIC: While we may take issue with some of the "science," "statistics," and "analyses" reported in the series, no one would take issue with the critical importance of infection prevention and control programs in health care facilities. We believe that it is important for the public to know that APIC has 10,000 members who are working in health care facilities across the United States to prevent and control infection. Our mission is to improve health care by reducing the risk of infection and related adverse outcomes. We agree that there are significant challenges to our work: increased patient acuity (sicker and more compromised patients), more sophisticated and invasive interventions that increase the risk of infection, lack of attention to hand washing (the most basic of prevention measures), inadequate nurse staffing leading to "shortcuts" in infection control techniques, development of multiple drug-resistant organisms as a result of misuse of antibiotics, and finally, decrease in infection control staffing levels as a result of health care facility efforts to cut operating costs. For 30 years, APIC has provided education, practice guidance, and resources for infection control professionals.
Our work is done in collaboration with governmental agencies [CDC’s division of healthcare quality promotion (DHQP)]; accreditation organizations (Joint Commission on Accreditation of Healthcare Organizations); and other professional associations (Society for Healthcare Epidemiology of America). APIC and its members are cognizant of the increasing costs for provision of health care. APIC is represented on CDC’s Hospital Infection Control Practices Advisory Committee. Recommendations for infection prevention and control developed by this national advisory committee are evidence-based and consider cost-to-benefit ratios.
In 1983, APIC established the Certification Board of Infection Control and Epidemiology (CBIC) whose purpose is the protection of patients and the public by ensuring through examination of infection control professionals’ competency to practice. Unlike many other certifying agencies that require only proof of continuing education credit for recertification, CBIC requires recertification by written examination every five years to maintain the use of the CIC credential.
• CDC: Preventing health care-associated infections is a critical component of the Department of Health and Human Services patient safety improvement initiative. Our goal is to eliminate threats to patient safety and ensure the highest quality health care for all Americans. The mission of the DHQP is to protect patients and health care personnel and to promote quality of health care. In order to accomplish its mission, DHQP is developing a new Internet-based knowledge system called the National Healthcare Safety Network (NHSN). (See Hospital Infection Control, July 2002, under archives at www.HIConline.com.)
Two main aspects of the network are reporting adverse events, including health care-associated infections, and disseminating information on preventing such events. Disseminating information on prevention strategies and data on reported adverse events is a critical part of the network. This network is an expansion and enhancement of current surveillance and monitoring capabilities (e.g, National Nosocomial Infection Surveillance System). The network will be compatible with the National Electronic Disease Surveillance System. When NHSN is fully implemented, any health care facility will be eligible to participate. In addition to NHSN, DHQP is addressing health care safety through its seven challenges: priorities it has identified to reduce health care-associated infections and other adverse events. (See HIC, July 2000, under archives at www.HIConline.com.)
DHQP has been involved in several prevention projects through collaborations with state and federal partners and universities. Some collaborations include the Prevention Epicenter Program, the Chicago Antimicrobial Resistance Project, the Pittsburgh Regional Health Initiative, and the Iowa Department of Public Health Patient Safety Program. All the projects focus on prevention of health care-associated infections and promotion of patient safety.